Leg ulcers are mainly caused by insufficient or impaired venous circulation in the veins of the leg. The most common chronic wound type – leg ulcers – constitute up to 70 percent of all chronic wounds. Leg ulcers are divided into three main types:
- Venous leg ulcers (70%)
- Arterial leg ulcers (10%)
- Mixed venous and arterial leg ulcers (10-15%)
Venous leg ulcers
Venous leg ulcers are caused either by dysfunction of the venous valves or an inadequate calf muscle pump. In both cases, blood isn’t sufficiently returned to the heart. This leads to higher venous pressure, which can cause edema. Also, the increased fluid level between the cells can result in cell death, leading to ulcers. That is why compression therapy is an essential part of treating venous leg ulcers.
Venous leg ulcers are often located in the gaiter area of the leg and characterized by:
- an irregular shape
- brown-colored pigmentation in the peri-ulcer skin area (often with eczema)
- normal foot pulse
Arterial ulcers
Arterial leg ulcers are caused by insufficient blood supply to the leg or feet due to arteriosclerosis. A reduced supply of oxygen and nutrients to the cells can result in tissue death and lead to ulcers. Vascular surgery may be needed to restore the supply of oxygen. Please note that arterial leg ulcers should not be treated with compression therapy.
Arterial ulcers are often located in the gaiter area and on the feet and characterized by:
- a fairly regular shape
- atrophic, pale peri-ulcer skin
- weak foot pulse
Mixed venous and arterial leg ulcers
Mixed venous and arterial leg ulcers are ulcers caused by both venous and arterial disease. The majority of patients diagnosed with mixed venous ulcers have ulcers of venous origin and develop arterial insufficiency over time.
Prevalence
According to the wound care prevalence data 2007 within the CIA World Factbook, leg ulcers affect nearly two million people, mostly elderly, in Europe and North America every year. As the number of elderly people increases, leg ulcers may increase as well – and measures should be taken to improve the care of these patients, both in primary care and community care.
Ulcer management
Biatain® / Contreet® foam dressings are effective solutions for exuding wounds and are suitable to use under compression.
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